Nestle, AAP Partnership half-baked

Would the American Cancer Society sign on a tobacco giant to fund a prevention campaign? Or would the American Diabetes Association get in bed with Krispy Kreme? Until this week, I thought not, but the American Academy of Pediatrics has teamed up with Nestle — makers of Baby Ruth, Butterfinger, and Haagen-Dazs — to battle childhood obesity.

What’s more, this partnership violates the spirit, if not the letter, of the Council of Medical Specialty Society’s Code for Interactions with Companies. The Code outlines ethical guidelines designed to avoid a conflict of interest between Medical Societies, such as the AAP, and for-profit companies that may support their programs:

We adopt this Code to reinforce the core principles that help us maintain actual and perceived independence. Adopting this Code helps to ensure that a Society’s interactions with Companies will be for the benefit of patients and members and for the improvement of care in our respective specialty fields. (Emphasis added)

Of note, the code explicitly prohibits direct support from a company in developing a guideline for clinical practice:

7.3. Societies will not permit direct Company support of the development of Clinical Practice Guidelines or Guideline Updates.

The AAP has signed onto the code, and, best I can tell, Nestle is a Company. So why is the Nestle Nutrition Institute funding development of a comprehensive program to educate parents and children about nutrition?

The AAP should not be taking money for an anti-obesity project from an institute whose parent company sells candy and ice cream — and hawks flawed advice designed to undermine breastfeeding mothers.

If the AAP is really “dedicated to the health of all children,” they should send that check back to Nestle and start over. American families deserve nothing less.

Alison Stuebe, MD, MSc, is a maternal-fetal medicine physician, breastfeeding researcher, and assistant professor of Obstetrics and Gynecology at the University of North Carolina School of Medicine. She is a member of the Academy of Breastfeeding Medicine.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

25 Responses

Hear hear! Why did AAP even bother to be a co-signer of the CMSS Code for Interactions with Companies? They singned on less than six months ago. Is their “pledge of allegisance” this vacuous? This is reminiscent of the 2002 “deal” cut by the AAP top-brass with Ross to allow the latter to buy-up and brand-stamp the AAP Breastfeeding Section’s book intended for distribution to families … without consulted the AAP BF Section (which was rightly horrified by the conflict-of-interest implicatoins).

AMEN! The AAP is a sham. As a pediatrician and former member, it just makes me ashamed. I know that others say we should work with the AAP to affect change but it seems more and more obvious the AAP only has its commercial and financial interests at heart. The committee on Breastfeeding is drowned out by the overwhelming interest in supporting corporate sponsors. How are parents supposed to get the message of the importance of breastfeeding and good nutrition when the AAP endorses Nestle?

Unfortunately, the CMSS code defines “Company” as a company that makes or markets health care related things to physicians. So it technically only applies to pharmaceutical companies, etc. And the clinical guidelines are for physician practices, not consumer education. I agree with you about questioning the spirit but it does not in fact violate the agreement. Specialty societies can adopt a broader definition of “company” however.

Do you know if AAP is developing the content independently? That’s an important question. The whole thing still stinks, but if Nestle has no influence on the content, it’s better than if they do. AAFP just went through something similar with Coca Cola and I’m surprised AAP didn’t watch and learn from that. Our Board learned a lot from how the Coke thing rolled out last year and we just vetted it in our Congress of Delegates–many people still unhappy but multiple safeguards in place, many added for the 2nd year of the contract, and we are influencing Coca Cola corp in positive ways. And, while Coke makes some bad stuff, I don’t think the company is considered “evil” in the ways that Nestle may be–particularly in the context of an alliance with AAP re childhood obesity.

Why doesn’t stuff like this make national news? Why do we all have to hear about Lindsay Lohan’s underwear but not know that our doctors are in bed with the companies producing the source of our health problems? Thank you for putting this info out there!

I am disgusted by this. American families look to AAP for honest, unbiased thoughts on what is the best way to raise our children. Then, just when you thik you’ve found an organization you can trust, this happens. It’s dissappointing.

Thanks Anne for sharing that fine-print-reading of the CMSS Code of Interactions with Companies, and I think you may have it right.

Nonetheless, I’m guessing that other CMSS definitions cover this cozy relationship between Nestle and AAP. The co-signer. Of the document that frowns on cozy relationships.

(1) ‘Corporate Sponsorship’ is an arrangement in which a company provides $$ or in-kind support for a “particular Society product, service, or event, and is then acknoewledged in connection with the product, service or event.” Now, you KNOW Nestle will want its name/brands on all those lovely hand-outs for parents.

(2) ‘Educational Grant” is $$ given by a company for the “specific purpose of supporting an educational or scientific activity offered by the Society.” Surely AAP is describing this program as an educational offering for parents?

Societies have an opportunity to strengthen, expand, and elaborate upon the provisions of the CMSS Code in their respective implementation plans, which the Code Task Force require of all signatories to the Code. The Task Force states that the Code provisions are only the minimum requirements.
Here is an opportunity for the AAP to expand its definition of companies to include the formula industry. Will it take advantage of the opportunity? Stay tuned. This might be an interesting project for the Section on Breastfeeding.

Jerry, they are. And the SOBr is. Perhaps, since so many of the ABM leadership are in the leadership of the AAP, you should ask us about what we are doing, privately, so we can send a less-confusing public message to those members serving both organizations.

Who can blame that scoundrel Nestle’ for trying to get in bed with the AAP. It wouldn’t be their first time marketing at the expense of children, like they have done in poor countries where they unscrupulously market infant formula. Now maybe they can get a professional plug from the AAP for their products. Shame on the American Academy of Pediatrics. Pediatricians are (were) probably the best of the lot considering that most doctors They have already mounted a witch hunt for mothers who don’t want doctor’s advice (re birth, vaccinations etc) and midwives because of the money they don’t get when women make informed decisions. Thank you but I will look out for my own child’s best welfare and thankfully I am educated and confident enough to be able to do so.

Is Dr. Stuebe sure that ACOG is squeaky clean? And Dr. Montgomery and the AAFP sure that Coke and obesity aren’t related? Is there an “evil” scale we’re not aware of? Why all the AAP hatred? They all have a share in the obesity epidemic.

You’re right — medical societies have a long and unfortunate history of teaming up with industry / pharma in the name of health. The intent of my post was not to bludgeon the AAP as an organization, but to point out the inherent conflict of interest in a Nestle-backed anti-obesity initiate. The AAP’s Section on Breastfeeding has worked tirelessly to improve breastfeeding support, clinician training and education, and policy in the US. When breastfeeding is discussed in the US press, there is nearly always a sentence, “The American Academy of Pediatrics recommends 6 months of exclusive breastfeeding, followed by continued breastfeeding for at least a year.” Without the AAP’s backing for this recommendation, breastfeeding advocates would be set back decades. But that doesn’t mean that it’s a good idea for the AAP to take funding from Nestle to fight obesity. I’ve frankly been taken aback by the scorched earth tone of many comments about this partnership on this blog and elsewhere. I remain dismayed by the fact that this Nestle-AAP anti-obesity alliance exists — and that’s why I stand by my call for the AAP to discontinue the program. But I am far more dismayed that, in the name of advocacy, people are calling for a wholesale abandonment of the AAP. There are many, many shades of grey in this debate, and when we cast the issues as black and white, we lose far more than we gain.

Well, I agree with y’all the AAP ought to be ashamed of themselves. As for the criticisms of blogs, that’s unfair. If the so-called ‘legitimate’ media fails in its reporting duties then its up to the “citizen journalists” to step in to gap! Good work, ABM

[…] far, this notable collaboration has drawn some criticism in the blogsphere, e.g., in the Breastfeeding Medicine blog, by DrAlison Stuebe: The AAP should not be taking money for an anti-obesity project from an […]

[…] far, this notable collaboration has drawn some criticism in the blogsphere, e.g., in the Breastfeeding Medicine blog, by DrAlison Stuebe: The AAP should not be taking money for an anti-obesity project from an […]

[…] far, this notable collaboration has drawn some criticism in the blogsphere, e.g., in the Breastfeeding Medicine blog, by DrAlison Stuebe: The AAP should not be taking money for an anti-obesity project from an […]

[…] far, this notable collaboration has drawn some criticism in the blogsphere, e.g., in the Breastfeeding Medicine blog, by DrAlison Stuebe: The AAP should not be taking money for an anti-obesity project from an […]

[…] far, this notable collaboration has drawn some criticism in the blogsphere, e.g., in the Breastfeeding Medicine blog, by DrAlison Stuebe: The AAP should not be taking money for an anti-obesity project from an […]

[…] far, this notable collaboration has drawn some criticism in the blogsphere, e.g., in the Breastfeeding Medicine blog, by DrAlison Stuebe: The AAP should not be taking money for an anti-obesity project from an […]